The 24 months clinical evaluation of class II bulk fill composite restorations

Document Type : Original Article

Authors

1 Ordu University, Faculty of Dentistry

2 Samsun Dental Health Center

3 Samsun Dental Health Center, Samsun

4 Restorative Dentistry, Göztepe Dental Health Center

5 Ordu University, Faculty of Dentistry, Department of Restorative Dentistry.

Abstract

Background: Resin Composite materials are widely used in daily clinical dentistry because of their moderate cost compared with ceramics, easy placement, adequate esthetics, ability to bond with enamel and dentine, and physico-chemical properties. Bulk-fill composite materials were introduced to reduce chairside time. These materials have properties such as optimal bond strength, decreased polymerization shrinkage, and reduced cuspal deflection. This in-vivo study compared the clinical performance of three different class II resin composite restorations.

Methods: Seventy-one patients (41 females and 30 males) aged 20–43 years with at least three approximal caries were included in the present study. Two hundred twenty-three teeth with approximal caries were restored with two bulk-fill composites (Tetric-N Ceram Bulk fill [TEC], Filtek Bulk Fill [FB]) and a posterior resin composite (Gradia Direct Posterior [GDP]). Two experienced dentists clinically evaluated the restorations with a 5x magnification loupe using the modified United States Public Health Service (USPHS) criteria at baseline and at 24 months.

Results: The chi-square test was performed for statistical analysis. The cumulative retention rate for all restorations at 24 months was 90.5%. Retention loss was observed for three TEC (6.1%), four FB (8.2), and seven GDP (14%) restorations. There was no statistically significant difference among the three resin composite restoration groups in color match, marginal adaptation, surface roughness, marginal discoloration, anatomical form, and secondary caries criteria (P > 0.05).

Conclusion: Bulk-fill composite restorations in class II slot cavities have the same clinical results as traditional posterior composite restorations.

Keywords

Main Subjects


1. Ölçer Us Y, Aydınoğlu A, Erşahan Ş, Erdem Hepşenoğlu Y,
Sağır K, Üşümez A. A comparison of the effects of incremental
and snowplow techniques on the mechanical properties of
composite restorations. Aust Dent J. 2024;69(1):40-8. doi:
10.1111/adj.12982.
2. Zhou X, Huang X, Li M, Peng X, Wang S, Zhou X, et al.
Development and status of resin composite as dental
restorative materials. J Appl Polym Sci. 2019;136(44):48180.
doi: 10.1002/app.48180.
3. Kaisarly D, El Gezawi M, Keßler A, Rösch P, Kunzelmann
KH. Shrinkage vectors in flowable bulk-fill and conventional
composites: bulk versus incremental application. Clin Oral
Investig. 2021;25(3):1127-39. doi: 10.1007/s00784-020-
03412-3.
4. Kunz PVM, Wambier LM, da Rosa Kaizer M, Correr GM, Reis
A, Gonzaga CC. Is the clinical performance of composite
resin restorations in posterior teeth similar if restored with
incremental or bulk-filling techniques? A systematic review
and meta-analysis. Clin Oral Investig. 2022;26(3):2281-97.
doi: 10.1007/s00784-021-04337-1.
5. Torres CR. Modern Operative Dentistry: Principles for
Clinical Practice. Springer Nature; 2019. doi: 10.1007/978-
3-030-31772-0.
6. Van Ende A, De Munck J, Lise DP, Van Meerbeek B. Bulk-fill
composites: a review of the current literature. J Adhes Dent.
2017;19(2):95-109. doi: 10.3290/j.jad.a38141.
7. Czasch P, Ilie N. In vitro comparison of mechanical properties
and degree of cure of bulk fill composites. Clin Oral Investig.
2013;17(1):227-35. doi: 10.1007/s00784-012-0702-8.
8. Tarle Z, Attin T, Marovic D, Andermatt L, Ristic M, Tauböck
TT. Influence of irradiation time on subsurface degree of
conversion and microhardness of high-viscosity bulk-fill
resin composites. Clin Oral Investig. 2015;19(4):831-40. doi:
10.1007/s00784-014-1302-6.
9. Besegato JF, Jussiani EI, Andrello AC, Fernandes RV, Salomão
FM, Vicentin BL, et al. Effect of light-curing protocols on
the mechanical behavior of bulk-fill resin composites. J
Mech Behav Biomed Mater. 2019;90:381-7. doi: 10.1016/j.
jmbbm.2018.10.026.
10. Barutcigil Ç, Barutcigil K, Özarslan MM, Dündar A, Yilmaz B.
Color of bulk-fill composite resin restorative materials. J Esthet
Restor Dent. 2018;30(2):E3-8. doi: 10.1111/jerd.12340.
11. Hickel R, Mesinger S, Opdam N, Loomans B, Frankenberger
R, Cadenaro M, et al. Revised FDI criteria for evaluating direct
and indirect dental restorations-recommendations for its
clinical use, interpretation, and reporting. Clin Oral Investig.
2023;27(6):2573-92. doi: 10.1007/s00784-022-04814-1.
12. Chesterman J, Jowett A, Gallacher A, Nixon P. Bulk-fill resinbased composite restorative materials: a review. Br Dent J.
2017;222(5):337-44. doi: 10.1038/sj.bdj.2017.214.
13. Hickel R, Peschke A, Tyas M, Mjör I, Bayne S, Peters M,
et al. FDI World Dental Federation: clinical criteria for the
evaluation of direct and indirect restorations-update and
clinical examples. Clin Oral Investig. 2010;14(4):349-66. doi:
10.1007/s00784-010-0432-8.
14. Loguercio AD, Reis A. Application of a dental adhesive using
the self-etch and etch-and-rinse approaches: an 18-month
clinical evaluation. J Am Dent Assoc. 2008;139(1):53-61. doi:
10.14219/jada.archive.2008.0021.
15. Yazici AR, Antonson SA, Kutuk ZB, Ergin E. Thirty-six-month
clinical comparison of bulk fill and nanofill composite
restorations. Oper Dent. 2017;42(5):478-85. doi: 10.2341/16-
220-c.
16. Heck K, Manhart J, Hickel R, Diegritz C. Clinical evaluation of
the bulk fill composite QuiXfil in molar class I and II cavities:
10-year results of a RCT. Dent Mater. 2018;34(6):e138-47.
doi: 10.1016/j.dental.2018.03.023.
17. Suneelkumar C, Harshala P, Madhusudhana K, Lavanya A,
Subha A, Swapna S. Clinical performance of class I cavities
restored with bulk fill composite at a 1-year follow-up using
the FDI criteria: a randomized clinical trial. Restor Dent
Endod. 2021;46(2):e24. doi: 10.5395/rde.2021.46.e24.18. Tirapelli C. Is the clinical performance of incremental
and bulk-fill resin composite different? Evid Based Dent.
2022;23(2):84. doi: 10.1038/s41432-022-0264-9.
19. Arbildo-Vega HI, Lapinska B, Panda S, Lamas-Lara C, Khan
AS, Lukomska-Szymanska M. Clinical effectiveness of bulkfill and conventional resin composite restorations: systematic
review and meta-analysis. Polymers (Basel). 2020;12(8):1787.
doi: 10.3390/polym12081786.
20. Uzel İ, Aykut-Yetkiner A, Ersin N, Ertuğrul F, Atila E, Özcan M.
Evaluation of glass-ionomer versus bulk-fill resin composite:
a two-year randomized clinical study. Materials (Basel).
2022;15(20):7271. doi: 10.3390/ma15207271.
21. Loguercio AD, Rezende M, Gutierrez MF, Costa TF, ArmasVega A, Reis A. Randomized 36-month follow-up of posterior
bulk-filled resin composite restorations. J Dent. 2019;85:93-
102. doi: 10.1016/j.jdent.2019.05.018.
22. Sengupta A, Naka O, Mehta SB, Banerji S. The clinical
performance of bulk-fill versus the incremental layered
application of direct resin composite restorations: a systematic
review. Evid Based Dent. 2023;24(3):143. doi: 10.1038/
s41432-023-00905-4.
23. Bayraktar Y, Ercan E, Hamidi MM, Çolak H. One-year clinical
evaluation of different types of bulk-fill composites. J Investig
Clin Dent. 2017;8(2):e12210. doi: 10.1111/jicd.12210.
24. Kubo S, Kawasaki A, Hayashi Y. Factors associated with
the longevity of resin composite restorations. Dent Mater J.
2011;30(3):374-83. doi: 10.4012/dmj.2010-191.
25. Schwendicke F, Kniess J, Paris S, Blunck U. Margin integrity
and secondary caries of lined or non-lined composite and
glass hybrid restorations after selective excavation in vitro.
Oper Dent. 2017;42(2):155-64. doi: 10.2341/16-095-l.
26. Heintze SD. Systematic reviews: I. The correlation between
laboratory tests on marginal quality and bond strength. II. The
correlation between marginal quality and clinical outcome. J
Adhes Dent. 2007;9 Suppl 1:77-106.
27. de Oliveira Araujo F, Vieira LC, Monteiro Junior S. Influence
of resin composite shade and location of the gingival margin
on the microleakage of posterior restorations. Oper Dent.
2006;31(5):556-61. doi: 10.2341/05-94.
28. de Almeida Campos PE, de Oliveira Barceleiro M, SampaioFilho HR, Martins LR. Evaluation of the cervical integrity
during occlusal loading of class II restorations. Oper Dent.
2008;33(1):59-64. doi: 10.2341/07-35.
29. Ástvaldsdóttir Á, Dagerhamn J, van Dijken JW, NaimiAkbar A, Sandborgh-Englund G, Tranæus S, et al. Longevity
of posterior resin composite restorations in adults – a
systematic review. J Dent. 2015;43(8):934-54. doi: 10.1016/j.
jdent.2015.05.001.
30. Espíndola-Castro LF, Guimaraes RP, de Souza FB, de Melo
Monteiro GQ, Fernandes LO, et al. A 14-year follow-up of
resin composite occlusal restorations: split mouth randomised
clinical trial and wear evaluation by optical coherence
tomography. J Clin Diagn Res. 2019;13(1):ZC10-15. doi:
10.7860/jcdr/2019/37436.12436.
31. Osiewicz MA, Werner A, Roeters FJ, Kleverlaan CJ. Wear
of direct resin composites and teeth: considerations for
oral rehabilitation. Eur J Oral Sci. 2019;127(2):156-61. doi:
10.1111/eos.12600.
32. Ferraris F, Conti A. Superficial roughness on composite
surface, composite-enamel and composite-dentin junctions
after different finishing and polishing procedures. Part II:
roughness with diamond finishing and differences between
enamel composite vs body composite. Int J Esthet Dent.
2014;9(2):184-204.
33. Albuquerque PP, Moreira AD, Moraes RR, Cavalcante LM,
Schneider LF. Color stability, conversion, water sorption
and solubility of dental composites formulated with different
photoinitiator systems. J Dent. 2013;41 Suppl 3:e67-72. doi:
10.1016/j.jdent.2012.11.020.
34. Paolone G, Formiga S, De Palma F, Abbruzzese L, Chirico L,
Scolavino S, et al. Color stability of resin-based composites:
staining procedures with liquids-A narrative review. J Esthet
Restor Dent. 2022;34(6):865-87. doi: 10.1111/jerd.12912.